Special Specimen Collection and Handling

URINE COLLECTION AND TRANSPORT (24 HOUR)

Urine Preservative and Transport List

Patient Instructions

To collect a 24-hour urine specimen:

  1. Follow your physician’s directions regarding intake of food, drink, or drugs before and during collection.
  2. Empty bladder completely on awakening in the morning and discard this urine specimen.
  3. Record date and time under “start” and begin the test (e.g., 5/12/10, 7:00 a.m.).
  4. All urine passed during the rest of the day and night for the next 24 hours must be poured into the container. Do not urinate directly into the container. Urine should be collected in another clean container and then carefully poured into the 24-hour collection container. (Note: If possible, keep container refrigerated during collection.)
  5. Make final collection the next morning at the same time and record under “finish.” (EXAMPLE: 5/16/08 @ 7:00 a.m.)
  6. Take the 24-hour specimen to your physician’s office or laboratory as soon as possible.

Lab Instructions

  1. Most 24-hour urine specimens can be collected in a clean, nonmetal container without preservatives if the specimen is refrigerated during the collection and transport to the laboratory. ARUP provides 24-hour collection containers (supply #16419) with peel-off labels to record times and volume; these containers can be affixed to containers and transport tubes.
  2. When the specimen is received by your laboratory:
    • Pool the entire collection into one container.
    • Mix the specimen 15–30 times by inversion of the sealed container.
    • Measure the total volume.
    • Record both the collection time and the total volume.
  3. If a single test is requested, refer to the Laboratory Test Directory to determine the required submission volume, the method of preservation, and acceptable transportation conditions.
  4. If multiple tests are requested, more than one method of preservation may be required. According to the Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, urine should not be collected at the same time for two or more tests for which different preservatives are required. However, if only a single 24-hour collection is available, and more than one method of preservation is specified for the tests that are ordered, use the following directions:
    • First, from the well-mixed specimen, remove aliquots of unpreserved urine for applicable tests.
    • Second, measure the pH of the well-mixed, unpreserved urine.

    For urines > 7 pH, adjust pH to basic level first, then to acidic level. If the pH is greater than 7 and a basic pH is required, adjust the pH of the entire remaining urine specimen according to instructions in the test entry. Mix well and remove the required aliquot(s). Secure cap and label appropriately. Next, if an acidic pH is required, adjust the pH of the remaining urine specimen according to instructions in the test entry. Mix well and remove the required aliquot(s). Secure cap and label appropriately.

    For urines < 7 pH, adjust pH to acidic level first, then to basic level. If the pH is less than 7 and an acidic pH is required, adjust the pH of the entire remaining urine specimen according to instructions in the test entry. Mix well and remove the required aliquot(s). Secure cap and label appropriately. Next, if a basic pH is required, adjust the pH of the entire remaining urine specimen according to instructions in the test entry. Mix well and remove the required aliquot(s). Secure cap and label appropriately.

  5. Urine specimens should be submitted in ARUP’s standard transport tubes unless otherwise specified. Pour 4.5 mL into each tube and secure cap. Complete the peel-off label with recorded time and volume, and affix to each ARUP standard transport tube.
  6. Label each aliquot with the following information:
    • Patient name
    • Patient identification number
    • Collection time and date
    • Total volume and collection duration
    • Specify preservative or no preservative pH value
    • Name of requested test

CORP-APPEND-0249I, Rev 1